DrugDosageAdverse effects
Short-acting bronchodilators

  • Albuterol DPI

  • Age > 11 years: 180 mcg every 4 to 6 hours as needed

  • Same as albuterol nebulized

  • Albuterol HFA

  • Age 4 to 11 years: 180 mcg every 4 to 6 hours as needed

  • Age > 11 years: 180 mcg every 4 to 6 hours as needed

  • Same as albuterol nebulized

  • Albuterol nebulized

  • Age < 2 years: 0.05 to 0.15 mg per kg every 1 to 6 hours as needed, max 1.25 mg per dose

  • Age 2 to 5 years: 0.1 to 0.15 mg per kg every 4 to 6 hours as needed, max 2.5 mg per dose

  • Age 5 to 11 years: 2.5 mg every 4 to 6 hours as needed, max 10 mg per day

  • Age > 11 years: 2.5 to 10 mg every 1 to 4 hours as needed

  • Angina, arrhythmia, bad taste, cough, dizziness, headache, hyperglycemia, hypertension, hypokalemia, nausea, nervousness, palpitations, tachycardia, throat irritation, tremor

  • Ipratropium/albuterol inhaled (Combivent)

  • Age < 13 years: 80 mcg/400 mcg to 160 mcg/800 mcg every 20 minutes as needed for up to 3 hours

  • Age ≥ 13 years: 160 mcg/800 mcg every 20 minutes as needed for up to 3 hours

  • Same as ipratropium/albuterol nebulized

  • Ipratropium/albuterol nebulized (Duoneb)

  • Age < 13 years: 0.25 mg/1.25 mg to 0.5 mg/2.5 mg every 20 minutes for three doses, then as needed for up to 3 hours

  • Age ≥ 13 years: 0.5 mg/2.5 mg every 20 minutes for 3 doses, then as needed for up to 3 hours

  • Angina, arrhythmia, cardiac arrest, glaucoma, hyperglycemia, hyperlactatemia, hypertension, hypokalemia, hypotension, pharyngitis

  • Levalbuterol HFA (Xopenex HFA)

  • Age 4 to 11 years: 90 mcg every 4 to 6 hours as needed, max 540 mcg per day

  • Age > 11 years: 90 mcg every 4 to 6 hours as needed, max 540 mcg per day

  • Same as albuterol nebulized

  • Levalbuterol nebulized (Xopenex)

  • Age 6 to 11 years: 0.31 to 0.63 mg three times a day as needed, max dose 0.63 mg

  • Age > 11 years: 0.63 to 1.25 mg three times a day as needed

  • Same as albuterol nebulized

Inhaled corticosteroids

  • Beclomethasone HFA

  • Age 5 to 11 years: 40 to 160 mcg per day

  • Age > 11 years: 40 to 640 mcg per day

  • Adrenal suppression, cataracts, cough, dysmenorrhea, dysphonia, eosinophilia, glaucoma, hypercorticism, growth suppression, Churg-Strauss syndrome, oral candidiasis, osteoporosis

  • Budesonide DPI (Pulmicort)

  • Age 6 to 11 years: 180 to 720 mcg per day

  • Age > 11 years: 180 to 1,440 mcg per day

  • Same as beclomethasone HFA

  • Budesonide nebulized (Pulmicort)

  • Age 1 to 8 years: 0.25 to 1.0 mg daily

  • Same as beclomethasone HFA

  • Ciclesonide HFA (Alvesco)

  • Age > 11 years: 80 to 640 mcg per day

  • Same as beclomethasone HFA

  • Flunisolide HFA (Aerospan)

  • Age 6 to 11 years: 160 to 320 mcg per day

  • Age > 11 years: 160 to 640 mcg per day

  • Same as beclomethasone HFA

  • Fluticasone furoate DPI (Arnuity Ellipta)

  • Age > 11 years: 100 to 200 mcg per day

  • Same as beclomethasone HFA

  • Fluticasone propionate DPI (Flovent Diskus)

  • Age 4 to 11 years: 100 to 200 mcg per day

  • Age > 11 years: 100 to 1,000 mcg per day

  • Same as beclomethasone HFA

  • Fluticasone propionate HFA (Flovent HFA)

  • Age 4 to 11 years: 88 to 176 mcg per day

  • Age > 11 years: 88 to 880 mcg per day

  • Same as beclomethasone HFA

  • Mometasone DPI (Asmanex)

  • Age 4 to 11 years: 110 mcg per day

  • Age > 11 years: 220 to 440 mcg per day

  • Same as beclomethasone HFA

  • Mometasone HFA (Asmanex HFA)

  • Age > 11 years: 400 to 800 mcg per day

  • Same as beclomethasone HFA

Long-acting beta2 agonists

  • Budesonide/formoterol (Symbicort)

  • Age > 11 years: 320 mcg/18 mcg to 640 mcg/18 mcg per day

  • Adrenal suppression, angina, arrhythmia, cardiac arrest, cataracts, cough, dysmenorrhea, dysphonia, eosinophilia, glaucoma, growth suppression, hypercorticism, hyperglycemia, hypertension, hypokalemia, hypotension, oral candidiasis, osteoporosis, palpitations, Churg-Strauss syndrome, tremor

  • Fluticasone/salmeterol DPI (Advair Diskus)

  • Age 4 to 11 years: 200 mcg/100 mcg per day

  • Age > 11 years: 200 mcg/100 mcg to 1,000 mcg/100 mcg per day

  • Same as budesonide/formoterol

  • Fluticasone/salmeterol HFA (Advair HFA)

  • Age > 11 years: 180 mcg/84 mcg to 920 mcg/84 mcg per day

  • Same as budesonide/formoterol

  • Fluticasone/vilanterol (Breo Ellipta)

  • Age ≥ 18 years: 100 mcg/25 mcg to 200 mcg/25 mcg per day

  • Same as budesonide/formoterol

Leukotriene receptor antagonists

  • Montelukast (Singulair)

  • Age 1 to 5 years: 4 mg every evening

  • Age 6 to 14 years: 5 mg every evening

  • Age ≥ 15 years: 10 mg every evening

  • Cough, dyspepsia, fatigue, gastroenteritis, headache, nasal congestion, Churg-Strauss syndrome, rare elevations of LFTs, rashA1

  • Zafirlukast (Accolate)

  • Age 5 to 11 years: 10 mg twice a day

  • Age ≥ 12 years: 20 mg twice a day

  • Diarrhea, headache, nausea, Churg-Strauss syndrome, rare elevations of LFTsA2

Leukotriene inhibitor

  • Zileuton (Zyflo)

  • Age > 12 years: 600 mg four times a day

  • Abdominal pain, dyspepsia, headache, myalgia, nausea; rare sleep disorders and behavior changesA3

Methylxanthines

  • Theophylline

  • 300 to 600 mg by mouth, divided, twice a day

  • Serum level < 20 mg per L (111 μmol per L): Headache, insomnia, nausea, vomiting

  • Serum level > 20 mg per L: Arrhythmias, seizuresA4

Cromolyn

  • 20-mg inhalation nebulizer four times a day

  • Cough, nasal congestion, nausea, sneezing, wheezingA5

Monoclonals

  • Omalizumab (Xolair)

  • Age > 12 years: 150 to 375 mg subcutaneously every 2 to 4 weeks

  • Headache, injection site reaction, pharyngitis, sinusitis, upper respiratory tract infection, viral infectionsA6